Potty Training: The Secrets for Success

For those of you following my potty training sagas on The Seahorse Lounge, you know that my efforts have been somewhat tanking even though I have another child I was pretty successful with the first go around. From the best age to begin, to her recommended steps and answers to common questions, I turned to Nonie Levi, M.A., MFT to flush out the best approach when it comes to tots on the pot.

What age do you recommend to toilet teach?
The average age for learning to use the toilet for bowel and bladder control is 28 months. It is not possible for children to have physical control until around 18 months. Early learners can start the process at 18 months and some children may not master it until four. T. Berry Brazelton, a noted pediatrician, did a study involving 1,170 children over a ten year period using a no pressure technique of toilet teaching. 80% of the children achieved daytime bladder and bowel control by 2-2 1/2. Control meaning no more than one accident a week. 20% of normal children had not learned, in fact 150 did not complete the process until 3 1/2 and 108 were not in control until age 4. So, you can view toilet learning as the first bell curve parents experience with their children. There are the early learners, then most children learn around 28 months followed by the late learners.

After the age of 5 if the child is having frequent accidents with urination or nighttime bed wetting, seek professional medical advice. Some children lack a hormone that may create more urinating accidents.

Nighttime dryness usually happens after daytime bowel and bladder control. Children who are on the late end for nighttime dryness — shortly before or after their 5th birthday — usually have a smaller bladder or are deep sleepers who do not wake up to their body signals.

Many of us mothers hear from older generations of mothers that they had their children potty trained by age two, when the average age to even attempt potty training these days seems to start at two. Why are kids seemingly being potty trained at an older age?
I feel there are many reasons children were taught earlier. Many more women were stay at home moms, most children did not go to preschool, there was a more relaxed atmosphere in the past compared to today’s faster paced lifestyles. For many parents there is a lot of anxiety on toilet teaching because of their busy lives and that anxiety filters down to their toddlers. In the toilet teaching process parents should take a relaxed, calm and encouraging approach which helps to create a more successful atmosphere.

Do you think a child waiting until they are older hinders their ability to learn? My thinking is the less time you are in diapers, the easier it is to “unlearn” going in your pants. Thoughts?
This is not a bad habit they need to unlearn but a skill they need to be taught and then master. There is also no window of opportunity that is the perfect time. You want to treat each child uniquely for whom they are and to start the process when they appear ready.

I’ve read many places to wait until your child is ready to be potty trained and they will let you know. I’ve also heard the saying, “You’ve never seen a bride or groom walk down the aisle in diapers” — however, when is it okay for a parent to say ‘enough is enough, it’s time to potty train you’?
They can, but most likely they won’t be too successful. Toddlers are in a naturally oppositional stage of their development and can become very uncooperative. There are two things for which I coach parents to never get in power struggles with their children about and that is what goes in and what comes out, for the parent will lose. I have heard many horrible stories, especially on elimination of feces where the child begins to hold their urge to defecate and it turns into a medical issue and/or a very messy problem.

What are the steps to toilet teaching?
There a three main steps, after a child shows the signs for readiness:

1) Preparing the child.
2) The actual leaving diapers behind and starting in underpants.
3) The learning period. All the things that occur after the toddler starts wearing underpants.

Signs of Readiness
Signs of readiness are physical, emotional and maturational and may not all occur at the same time.

Some signs for bowel control are not having a B. M. during the night, pausing in play, crying or stating “poopy” while defecating.

Some signs of readiness for bladder control include: a dry diaper for an hour or two or longer during the day and occasional dry diaper after naps. This means the bladder is maturing and your child can hold urine for longer periods of time. Maturational signs may include an interest in cleanliness and increased self awareness.

Many children may be physically ready but not emotionally. Once your child shows sign of readiness it is time to prepare them for the process.

Preparing the Child
Preparing involves teaching and educating them about their body and the physical sensations related to elimination. Such as, getting a toilet or let them use the big one, practicing as often or little as they want, reading children’s books about using the toilet, teaching them the words to use, watching others use the toilet, let them explore the potty — to name a few.

Making the Switch to Underpants
Once they are prepared you can start them on step two and have them wear underpants. Forewarn them a day or week ahead they will start to wear underpants. You might want to delay the start if the child is extremely opposed to the idea and doesn’t respond to encouragement. Buy the thicker training pants for they absorb more urine when the child has accidents. I suggest — if possible — to take two to three quiet days at home to start the process. Assist your child to get on their underpants, especially if they are younger and haven’t mastered pulling up/down their pants.

Lead them to the potty and tell them this is where their urine and feces will go. Have them try and if they go acknowledge it. Do not overly praise or cheerlead their success. It takes away from their learning process when we make it a big deal. Does anyone clap for you after you have a bowel movement? Remember it is a normal body function. Tell them to let you know when they have to go again.

Then…..wait for the dreaded accident to happen. Accidents are valuable lessons in the learning process. Acknowledge the feelings they might have such as, feeling surprised, angry or sad. Then lead them to the potty to see if a little more can come out. This affirms where they should have urinated. Help them get some new clean pants and put them on. Most accidents are because of slow physiological development, insecurity or anxiety and ignoring body signals when in intense play. The appropriate response to these are patience, reassurance and gentle reminders. Keep your child in underpants for all waking activities and put on diapers for naps and nighttime. Stay with the process unless your child is extremely oppositional to wearing underpants, bewildered by the process or has very few successes after 4-5 days. Remember, they are toddlers and they may protest at times, a little encouragement and/or choices will help them adjust to this new skill.

The Learning Period
The learning period is the last part and is the hardest for parents to understand, because it varies for every parent, child and family. If the child is on the younger side they might have more accidents because of their smaller bladder size, having more difficulty mastering the skills, their emotional maturity, the way a parent might handle it based on their parenting style or their attitudes and beliefs or the child’s temperament.

Common Questions
The learning period is where parents have the most questions. Some common ones are:

– Should they use pull-ups?
Only if they will be on an airplane or attending a fancy event such as a wedding. Do not use them in the process because they act like diapers and the child does not feel the urine running down their leg or soaking their clothes.

– My child will not poop on the toilet?
I usually have 2-3 people with this issue at each talk. I believe children who refuse to poop on the toilet may have had constipation as a young baby or they have a more challenging temperament and are more persistent. Tell them you are willing to have them put on a diaper and they can poop there and then you’ll put them back in underpants. I would tell them you are unwilling to have them poop in their underwear because it is messy and harder to clean up than in a diaper. Give them the choice to either poop on the toilet or in the diaper.

–My child refuses to wear underwear and start the toilet teaching process. What do I do?
On the first day of each month tell the child “Your Daddy and I feel you are ready to start wearing underpants and go on the potty. Are you ready?” If the answer is no then ask again on the first day of each month making the positive statement that you know they are ready. This is the only time I suggest you ask a toddler a question for which no could be the answer. Remember do not get in a power struggle over what comes out!

-Should I bribe them?
I suggest not to. Again, no one gives me a chocolate after I use the bathroom. It is a normal body function the child will learn with time and encouragement. It also reinforces children to be motivated by external reward rather than through their own achievement and personal successes. Teaching a child to be intrinsically motivated has a tremendous lifelong value.

Most professionals feel that parents whose children learn to use the toilet most easily have a calm, patient and matter-of fact attitude toward toilet teaching; communicate clearly what behaviors are expected of the child; anticipate gradual rather than instant success; do not use punishment, scolding or shaming; observe when the child is ready; encourage the child for their success; are understanding about accidents; switch from diapers to underpants when the child is ready and are not hesitant and send a clear message that they have confidence in the child’s ability to learn.

Nonie Levi, M.A., MFT is a Licensed marriage and family therapist who teaches a potty training course 3-4 times a year through San Diego’s Parent Connection. For more information on Nonie and/or to get in touch with her, please visit sandiegotherapists.com

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